Coaching and Concussion

Over the last few months at the Old Mid-Whitgiftians, where I work as Director of Rugby for the club, we have had a particularly tough time with concussions within the club. The range of the injuries and the impact they have had on both us as a club and the individuals involved has been a little bit concerning. And when we reviewed each incident it highlights just how difficult it is for clubs to determine the extent of a player’s problems. And to make it clear, our very competent physio has struggled with making decisions on whether a player is discussed because, other than practical hands on experience, there is no way we can support or improve her learning as there just isn’t the suitable medical training course you can put people through, and it isn’t physically possible to have a head trauma specialist at every game in the premiership, let alone at level 8 rugby.

In the spate of two weeks we had 3 very different cases to consider and each of them presented in very different ways.

In the first game, two players were concussed, the first player, the hooker there were recognisable signs that he may be concussed and the decision was made by the physio that he wasn’t fit to continue, and so we removed him from play. Upon further evaluation off the field and after the game it was then decided that he had just had a blow to the head, rather than suffering a concussion, however as a coach I decided to make him rest for two weeks as a precaution.

The second player injured in the game was our prop, at the time the decision was that he was just a bit dazed by the blow and certainly the way he was communicating gave us no indication that he was concussed. However at training on Tuesday a slight brush against the head and the player started suffering from blurred vision and feeling like he was going to vomit. Although again it was determined by the physio he wasn’t concussed, he was sent home with strict instructions to monitor himself and if things didn’t improve within the hour he was to go straight to hospital. The player did end up in hospital and shockingly it was discovered that he had actually had a hairline fracture in his skull. It is believed that the player suffered the fracture on the pitch and was concussed on both occasions. He returned to the bench 5 weeks later and time will tell if there is anymore damage done, but as a coach it does fill me with a certain amount of fear putting him back on the pitch so soon, but he has had all the medical clearance needed to play.

The third player was injured the week after and came off during the game. During the evening he wasn’t well but gave the impression that all was well. He ended u in hospital over the weekend and after tests it was determined that he had suffered a minor bleed and that he was concussed. 3 weeks later he was cleared to play.

The purpose of this story is to highlight that it is becoming increasingly difficult to diagnose head injuries and the severity of them and the long term health impact it might have on the player. As a coach I live with a certain amount of fear about something tragic happening on the field with a player I coach, how well prepared are we really to be able to diagnose a problem we have had little or no training in, and quite frankly we don’t really know where to go to get that training. Certainly given the severity of head injuries is on the increase, surely the IRB or the RFU need to act and provide the right sort of training to clubs. Having attended a First Aid for Sport training day, I am even less convinced that the RFU are interested in helping to solve the problem.

Is it simply that we start asking all players to wear head guard, because the RFU waffle seems to suggest they are actually keen to ban head guards because they have made players braver and more inclined to put their heads in where they shouldn’t be going. As a coach and a fan I don’t know what the answer is, but surely both the IRB and the RFU should have some interest in finding both preventative measures and improving medical training and awareness

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